<div id="" class="formio-component formio-component-form  formio-component-label-hidden" ref="component">
  <div class="formio-form formio-read-only" ref="webform" novalidate>
    <div id="requestedCovers.HOUSECONTENT_JEWELRY" class="mb-2 formio-form-group has-feedback formio-component formio-component-checkbox formio-component-requestedCovers.HOUSECONTENT_JEWELRY " ref="component">
      <div class="form-check checkbox">
        <input ref="input" id="requestedCovers.HOUSECONTENT_JEWELRY-requestedCovers.HOUSECONTENT_JEWELRY" aria-labelledby="l-requestedCovers.HOUSECONTENT_JEWELRY-requestedCovers.HOUSECONTENT_JEWELRY" name="data[requestedCovers.HOUSECONTENT_JEWELRY]" type="checkbox" class="form-check-input" lang="en" disabled="disabled" value="0" aria-required="false">
        <label class=" form-check-label" for="requestedCovers.HOUSECONTENT_JEWELRY-requestedCovers.HOUSECONTENT_JEWELRY" id="l-requestedCovers.HOUSECONTENT_JEWELRY-requestedCovers.HOUSECONTENT_JEWELRY">
          <span>Checkbox</span>
        </label>
      </div>
      <div ref="messageContainer" class="formio-errors invalid-feedback"></div>
    </div>
    <div id="currency" class="mb-2 formio-form-group has-feedback formio-component formio-component-currency formio-component-currency " ref="component">
      <label ref="label" class="col-form-label " for="currency-currency" id="l-currency-currency">
        Currency
        <span class="visually-hidden">, numeric only,</span>
      </label>
      <div ref="element">
        <input ref="input" name="data[currency]" type="text" class="form-control" lang="en" disabled="disabled" inputmode="decimal" value="" id="currency-currency" aria-labelledby="l-currency-currency " aria-required="false"></input>
      </div>
      <div ref="messageContainer" class="formio-errors invalid-feedback"></div>
    </div>
    <div id="submit" class="mb-2 formio-form-group has-feedback formio-component formio-component-button formio-component-submit  mb-2 formio-form-group" ref="component">
      <button ref="button" name="data[submit]" type="submit" class="btn btn-primary btn-md" lang="en" disabled="disabled">
        Submit
      </button>
      <div ref="buttonMessageContainer">
        <span class="help-block" ref="buttonMessage"></span>
      </div>
      <div ref="messageContainer" class="formio-errors invalid-feedback"></div>
    </div>
  </div>
  <div ref="messageContainer" class="formio-errors invalid-feedback"></div>
</div>